[Cerebral perfusion in patients with arterial hypertension and chronic forms of brain vascular pathology].

Aim: To examine cerebral perfusion in patients with dyscirculatory encephalopathy and residual disorders of cerebral circulation in arterial hypertension.

Material And Methods: Duplex scanning of extra- and intracranial arteries, computed tomography of the head were performed in 26 hypertensive patients with chronic vascular pathology of the brain. Cerebral perfusion was studied by the evidence obtained at single-photon emission computed tomography.

Results: Impaired segmental perfusion of the brain, primarily of frontal and temporal location, was detected in 88.5% patients. Occlusive lesions of extra- and intracranial arteries were accompanied by significant deterioration of the perfusion while visualization of leukoaraosis was associated with high perfusion in the anterior frontal compartments indirectly pointing to defects in autoregulation of cerebral circulation. It was found that different correlations exist between perfusion of various segments of the brain and systemic arterial pressure. This is explained by functional and hemodynamic heterogenicity of different brain regions.

Conclusion: Specific features of cerebral perfusion in patients with chronic forms of vascular brain pathology should be considered in planning antihypertensive therapy because of the risk of focal hypoxia and even ischemia in an inadequate fall of arterial pressure.